Sarnat H B, Sarnat M S
Arch Neurol. 1976 Oct;33(10):696-705. doi: 10.1001/archneur.1976.00500100030012.
Twenty-one neonates of over 36 weeks' gestation suffered perinatal asphyxia but not chronic hypoxia. Three clinical stages of postanoxic encephalopathy were distinguished. Stage 1 lasted less than 24 hours and was characterized by hyperalertness, uninhibited Moro and stretch reflexes, sympathetic effects, and a normal electroencephalogram. Stage 2 was marked by obtundation, hypotonia, strong distal flexion, and multifocal seizures. The EEG showed a periodic pattern sometimes preceded by continuous delta activity. Infants in stage 3 were stuporous, flaccid, and brain stem and autonomic functions were suppressed. The EEG was isopotential or had infrequent periodic discharges. Infants who did not enter stage 3 and who had signs of stage 2 for less than five days appeared normal in later infancy. Persistence of stage 2 for more than seven days or failure of the EEG to revert to normal was associated with later neurologic impairment or death.
21名孕龄超过36周的新生儿发生围产期窒息，但无慢性缺氧。区分了缺氧后脑病的三个临床阶段。第1阶段持续时间少于24小时，其特征为过度警觉、莫罗反射和牵张反射不受抑制、交感神经效应以及脑电图正常。第2阶段的特征为意识迟钝、肌张力减退、强烈的远端屈曲和多灶性惊厥。脑电图显示周期性模式，有时之前有持续性δ活动。第3阶段的婴儿昏迷、松弛，脑干和自主神经功能受到抑制。脑电图呈等电位或有不频繁的周期性放电。未进入第3阶段且第2阶段体征持续少于5天的婴儿在婴儿后期看起来正常。第2阶段持续超过7天或脑电图未能恢复正常与后期神经功能损害或死亡有关。
